Provider Demographics
NPI:1275881047
Name:THOMAS, LAUREN IRENE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:IRENE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 25TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-5823
Mailing Address - Country:US
Mailing Address - Phone:206-616-7192
Mailing Address - Fax:206-616-7304
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356320
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-616-7192
Practice Address - Fax:206-616-7304
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGT60267230170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS